Clinical significance of new-onset atrial fibrillation in patients with coronary artery or peripheral artery disease: results from the COMPASS trial
Bibliographic record
Abstract
Abstract Background The COMPASS trial enrolled patients with coronary artery or peripheral artery disease, but excluded patients requiring oral anticoagulation. Compared to aspirin alone, rivaroxaban in addition to aspirin reduced a composite of cardiovascular death, stroke or myocardial infarction. Purpose This study aimed to explore the clinical significance of a new diagnosis of atrial fibrillation (AF) during follow-up. Methods New AF was identified from unplanned hospitalization, study drug discontinuation and adverse event reports. The associations between new-onset AF, clinical characteristics and outcomes in COMPASS participants were studied using time-updated regression modeling. Event rates were reported as per 100 patient-years (following a new diagnosis of AF vs. from randomization until the end-follow-up or new AF, whichever came first). Results During a mean follow-up of 23 months, 655 of 27,395 participants (2.4%) were newly diagnosed with AF. Advanced age, male sex, white race, higher body mass index, higher systolic blood pressure, heart failure and prior myocardial infarction were independently associated with new-onset AF. The rates of permanent discontinuation of study drug were 83.8% following a new diagnosis of AF, compared to 17.5% in participants without/before new AF. Compared to participants without/before a new diagnosis of AF, participants with new-onset AF were at increased risk of a composite of cardiovascular death, stroke or myocardial infarction (8.9 vs. 2.5 per 100 patient-years, hazard ratio [HR] 4.49, 95% confidence interval [CI] 3.37-6.00) (Figure 1). Risk increases with new-onset AF were also observed for hospitalization for heart failure (9.1 vs. 1.1 per 100 patient-years, HR 6.35, 95% CI 4.59-8.80) (Figure 2) and major bleeding (4.1 vs. 1.3 per 100 patient-years, HR 2.93, 95% CI 1.99-4.33). Conclusion In COMPASS, a new diagnosis of AF during trial follow-up was associated with a marked increase in risk of adverse outcomes.Composite outcome after new-onset AFHeart failure after new-onset AF
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".